Diverticulitis is a common reason people come to my office with sudden pain on the lower left side of the belly. It happens when small pouches in the wall of the colon, called diverticula, become inflamed or infected. Plenty of people have these pouches and never feel a thing. When one flares up, though, the pain can be sharp and hard to ignore. Here is what causes diverticulitis, how it is treated, and the food choices that help you recover and lower the odds of it happening again.
What Diverticula and Diverticulitis Are
Diverticula are small, balloon-like pouches that push out through weak spots in the colon wall. Having them is called diverticulosis, and it is very common after age 40. Most people with diverticulosis have no symptoms. Diverticulitis is what we call it when one or more of these pouches becomes inflamed or infected, which leads to pain and other symptoms.
Symptoms of Diverticulitis
The main symptom is pain, usually in the lower left side of the abdomen, that can come on quickly and stay for days. Other symptoms include:
- Fever and chills
- Nausea or vomiting
- Constipation, or less often, diarrhea
- Bloating and tenderness when you press on the belly
- Loss of appetite
What Causes It and Who Is at Risk
A low-fiber diet is a major factor, because it leads to harder stool and more pressure in the colon. Other things that raise your risk include older age, being overweight, smoking, not getting much exercise, and the regular use of certain pain medications like NSAIDs. Genetics play a part too, so a family history matters.
How Diverticulitis Is Diagnosed
I start with your symptoms and an exam, then usually confirm the diagnosis with a CT scan, which shows the inflamed pouches and tells us how severe the attack is. Blood tests check for signs of infection. Once the inflammation has settled, I often recommend a colonoscopy a few weeks later to look at the colon and rule out other problems.
Treatment
Treatment depends on how bad the attack is.
Mild Cases
Many mild cases are treated at home with rest, a short period on clear liquids and low-fiber foods while the colon settles, and antibiotics when needed. Most people start to feel better within a few days.
Severe Cases
A severe attack, or one with a complication such as an abscess, may need treatment in the hospital with intravenous antibiotics and fluids. A small number of people need a procedure to drain an abscess, and a few need surgery, usually for repeated attacks or complications.
What to Eat During a Flare
While the colon is inflamed, the goal is to give it a rest. I usually suggest starting with clear liquids such as water, broth, and clear juices, then slowly adding low-fiber foods like white toast, white rice, eggs, and well-cooked vegetables as the pain improves. Once you have fully recovered, you can return to your normal diet.
The Diet That Helps Prevent Future Flares
Between attacks, a high-fiber diet is one of the best ways to protect your colon. Fiber keeps stool soft and lowers pressure in the colon. Good sources include fruits, vegetables, beans, and whole grains. Add fiber slowly and drink plenty of water so you do not trade one problem for gas and bloating. Staying active and keeping a healthy weight help too.
You may have heard that people with diverticulosis should avoid nuts, seeds, and popcorn. Research has not supported that idea, and for most people these foods are fine. If a specific food seems to bother you, it is reasonable to limit it, but a blanket ban is not needed.
When to Get Medical Care
Call your doctor if you have ongoing belly pain with a fever, or pain that is getting worse. Seek care right away for severe pain, a high fever, vomiting that will not stop, or blood in your stool. These can be signs of a complication that needs prompt treatment.
Talk to a Gastroenterologist in Mountainside, NJ
If your symptoms keep coming back or you are not sure what is causing them, Dr. Amber Khan can help. We see patients from across Union County and New Jersey.